Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Previous exam questions > Previous exam Qs > Flashcards

Previous exam Qs Flashcards

1
Q

2 blood tests for alcohol dependence

A

MCV - macrocytic anaemia (due to low B12 and folate)

GGT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What investigation should be undertaken before treating opiate addiction?

A

ECG - before giving methadone as it can prolong QT and cause sudden cardiac death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

2 treatments for detox of opiates

A

methadone

buprenorphine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 features of alcoholic dependence syndrome

A 
Increased tolerance
Physiological withdrawal symptoms
Difficulty controlling quantity
Cravings
Loss of control
Preoccupation with drug taking behaviour
Continuation despite adverse effects
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is depersonalisation

A

the feeling of not feeling real, feeling detached and not capable to feel emotion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is derealisation

A

altered perception that the external world is unreal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is it called when you feel like you are going to die

A

Sensation of impending doom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Endocrine causes of panic attack

A

Phaeochromocytoma (tumour in the adrenal medulla –>increase in adrenaline)
Cushings disease (tumour in the pituitary –> increase in ACTH and cortisol)
Carcinoid syndrome (neuroendocrine tumour leads to high serotonin)
Hyperthyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Treatments of panic disorder

A

CBT
Antidepressants
Low intensity talking therapies if mild

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

3 signs of preterm labour

A 
PROM
open cervical os
contractions
pathological CTG 
pressure in pelvis
vaginal spotting
lower back pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

3 investigations for a placental abruption

A

Blood tests (FBC, clotting, group and save)
Kleihauer test for Rhesus negative
USS
CTG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

2 managements for abruption

A

Give steroids
Give anti-D of rhesus negative
Group and save/cross-match
Active management for 3rd stage of labour (syntocinon, ergometrine etc)
Deliver the baby if >34 weeks or in unstable fetus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Differentials for mass bleeding and pain

A

threatened miscarriage
ruptured/haemorrhaged ovarian cyst
ectopic pregnancy
fibroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

if a woman has a positive Bhcg what is the definitive investigation

A

TVUS - see if there is anything in the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

6 symptoms of depression

A 
anhedonia
anergia
low mood
loss of libido
lack in appetite
suicidal ideation 
feelings of helplessness and hopelessness
disturbed sleep
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

3 cognitive symptoms of depression

A

lack of concentration
forgetfulness
low motivation
difficulty making decisions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Name the screening tool for depression

A

PHQ 9 or HAD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

3 management strategies for depression

A 
CBT
computerised CBT
group CBT
interpersonal therapy (IPT)
SSRIs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define incidence

A

the number of new cases in a given period of time over the total population at risk at the give time

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

TB XR signs

A 
bihilar lymphadenopathy
ghon focus
non-caseating granuloma
consolidation
pleural effusion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

2 investigations for TB

A

3 deep cough sputum samples

XR
CT thorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

4 treatments of TB and a SE for each

A

Rifampicin (orange wee)
Isoniazid (peripheral neuropathy)
Pyrazinamide (hepatitis)
Ethambutol (optic neuritis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

3 GI features and 3 non GI features of Crohns

A

GI features

  • diarrhoea
  • abdo pain
  • mouth sores
  • bloody stool
  • weight loss

Non GI features

  • arthritis
  • erythema nodosum
  • primary sclerosing choleangitis
  • malabsorption (vitamin deficiencies)
  • clubbing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

3 features on histology of Crohns

A 
Transmural inflammation
Lymphocytes
Crypt atrophy
Granulomas
Oedema
Skip lesions
Terminal ileum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Staining of TB

A

Ziehl Neillson test - acid fast bacilli

Lowenstein Jensen test - specific for TB

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

4 SEs to steroids in young girl

A 
Acne
Difficulty sleeping
Weight gain
Excess hair
Deepened voice
Clitoral enlargement
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

If there is a cord lesion and vibration and proprioception is spared what column was spared

A

DCML

dorsal column medial lemnisus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

If there is a cord lesion and pain and temperature is lost what column was severed

A

Spinothalamic (lateral)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What tract carries the motor neurones

A

Corticospinal

decussates in the pyramids so that is why you get extrapyramidal signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What plantars do you have an UMN

A

upgoing (Babinskis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How do you assess mental state

A

GPCOG
MMSE
6CIT
AMT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Causes of confusion in the elderly

A 
D - drugs
E - eyes, ears and other sensory impairment
L - low O2 state
I - ictal state 
R - retention of urine or stool
I - infection
U - under hydrated
M - metabolic disturbances
S - subdural
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

2 nursing strategies for confusion

A 
quiet room
good lighting
calandars
clocks
rehydrate
feed
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

4 metabolic/endocrine tests for hypoactive sexual desire disorder (HSDD)

A 
testosterone
low oestrogen
hypercholestrolaemia
DM
prolactin (hyperprolactinoma decreases libido)
TFTs (hypothyroidism)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

2 non metabolic/endocrine causes of HSDD

A

Depression
Anxiety
Relationship problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

2 treatments for HSDD

A 
Cabergoline for hyperprolactinaemia
Couples therapy
Testosterone
Flibanserin
Sensate focus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Describe the swiss cheese model

A

Cheese slices are barriers to error propagation

Holes - failures in the barriers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

4 principles of clinical negligence

A

was there a duty of care
was there a breech in this duty of care
did the patient come to harm
was the harm due to the breech

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

RDA for men and women on alcohol

A

14 units

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

type of anaemia in alcoholism

A

marcocytic anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

cause of macrocytic anaemia

A

B12 and folate deficiency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

what liver enzyme is elevated in alcoholism

A

GGT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Causes of haematemesis in alcoholism

A

mallory weiss tear
bleeding varices
gastritis
peptic ulcer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

alcoholism signs on inspection of abdomen

A

ascites
hepatomegaly
splenomegaly
spider naevi

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Treatment of delerium tremens

A

diazepam, chlorodiazepoxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Enlarged prostate investigations

A

PSA
transrectal US
prostatic biopsy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

How do you assess the extent of cancer spread

A

CT abdomen and chest
Alkaline phosphotase
Isotope bone scan
Serum calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

3 treatments in prostate cancer

A

prostate surgery
radiotherapy
anti-androgen therapy (flutamide)
orchidectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

pt with prostate cancer becomes more unwell increase in urinary frequency, thirsty, constipated, less mentally sharp what is causing this

A

hypercalcaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

immediate treatment for hypercalcaemia

A

IV fluids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

how do you treat hypercalcaemia in the long term

A

bisphosphonates

diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Immediate treatment of suspected meningitis at GP

A

IM Ben Pen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Bacterial meningitis on CSF

A

raised protein
decreased glucose
increased WCC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Childhood vaccinations to prevent meningitis

A

HiB

Men C

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Prophylactic treatment of meningitis in close contacts

A

Rifampicin

Ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Most common malignant neoplasm to affect the breast

A

adenocarcinoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

genes in breast cancer

A

BRCA 1 and 2

p53

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

where does breast cancer first metastasise too

A

axillary lymph nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

what cancers metastasise to the bone

A 
bronchus
thyroid
kidney
prostate
breast
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What special laboratory tests should be carries out on the biopsy tissue of breast lump

A

oestrogen receptor status

HER-2 status

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What systolic murmur is heard all over the precordium and over the carotid arteries and can cause collapse

A

aortic stenosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What measurement on a CXR would show that the heart is enlarged

A

cardiothoracic ratio > 0.5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

what can causes a double cardiac shadow on the right side of the heart

A

enlarged left atrium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Left ventricular hypertrophy signs on ECG

A

R wave in V5 or V6 of over 25mm
S wave in V1 or V2 of over 25 mm
Sum of S wave in V1 plus R wave in V6 of over 35mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Other abnormalities on a patient with aortic stenosis and LVH

A 
Left bundle branch block
T wave inversion in LV chest leads
Left axis deviation
Left bundle branch block
P mitrale (or equivalent)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

2 long-term consequences from LVH

A 
sudden death
arrhythmias - AF, VT
Left heart failure
Angina
Right heart failure
Cerebral Embolus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

How does fluoxetine act

A

Inhibit the neuronal reuptake of serotonin from synaptic cleft therefore increasing its bioavailability
Downregulate the number of 5HT receptors
Acts in the prefrontal cortex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What is the minimum time for antidepressants to be taken and why?

A

6 months

To prevent relapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Apart from 5HT receptors what other receptors do TCAs block and what SEs do they cause

A

Muscarinic receptors - dry mouth, constipation, urinary retention and blurred vision
Histamine receptors - sedation
Alpha 1 receptors - hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

What would make you think a patient has had an overdose of paracetamol

A 
Tachycardia
Dilated pupils
Enlarged bladder
Hypotensive
Unconsious
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What inheritance pattern is Alzheimer’s disease and what is the chance of a child getting the condition

A

Autosomal dominant

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

What BP med leads to postural HTN

A

Loop or thiazide diuretics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

2 activities to reduce postural HTN

A

sit up slowly and rest before standing

raise and lower arms 5 times before standing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

In a Parkinsons patient what neurological sites account for tremor, BP and incontinence

A

Basal ganglia
Corpus Striatum
Nigrostriatal tract
Sympathetic autonomic NS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

3 infectious disease causes of hepatomegaly

A 
Typhoid
Glandular fever
Toxoplasmosis
CMV
Hepatitis
Malaria
Schistosmiasis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Name an antibiotic that is a DNA gyrase inhibitor

A

ciprofloxacin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Where do serum transaminases come from?

A

hepatocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the blood test confirms glandular fever

A

Monospot

EBV IgM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

What cells proliferate in glandular fever

A

Epithelial cells

B lymphocytes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Why does anaphylaxis lead to hypotension

A

Hypovolaemic shock

vasodilation causes increase vascular permeability and fluid loss into the vascular space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

State the class of the immunoglobulin, the name of the cell and the name of the chemical mediator involved in anaphylaxis.

A

ANAPHYLAXIS
IgE
Mast cells
Histamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Treatment of anaphylaxis and route

A

IM adrenaline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Hyperkalaemia

A

Absent p waves
Tall tented T waves
Wide QRS complex
Prolonged PR interval

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

What drug treatment is given to immediately decrease high serum potassium?

A

Calcium gluconate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What drugs do you need to administer to this patient to ensure that potassium ions enter cells from the extracellular fluid?

A

Insulin

Dextrose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Agitated patient with hallucinations comes into A&E – treated with 5mg IV Halperidol. After a few minutes develops jerking/rigidity of neck and jaw muscles. What is this reaction called

A

Acute dystonic reaction - intermittent spasmodic or sustained involuntary contractions of muscles in the face, neck, trunk, pelvis, extremities, and even the larynx after the administration of a neuroleptic drug

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What is an oculogyric crisis

A

when the eyes roll backwards into the head

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Name 2 atypical antipsychotics

A 
Olanzapine
Arirpiprazole
Risperidone
Clozapine
Quetiapine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Name 2 drug classes that can cause delerium

A 
Benzodiazepines
Steroids
Opioids
Analgesics
Antihypertensives
Anti-histamines
Tricyclic antidepressants
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

2 treatmenta after a TIA

A

Clopidogrel
Statin
BP medication
Warfarin (target INR 2.5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

2 medical causes of premature ejaculation

A

Hyperthyroid
Prostate disease
Drugs - cocaine and amphetamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

3 psychosexual causes of premature ejaculation

A 
Anxiety about sexual problems
Early learned experience
Inexperience
Stress
Relationship problems
Depression
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

4 treatments for premature ejaculation

A 
Dapoxetine
Anitdepressants
Topical anaesthetics
Couples therapy
Stop and start sex
Hold breath
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What anaemia would bleeding fibroids cause

A

Iron deficiency anaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

2 symptoms to assess whether there was any pressure in the pelvic region

A

Heaviness in the pelvis
Discomfort when lying down or bending forward
Constipation
Increase in urinary frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

3 treatments (1 medical, 1 surgical, 1 radiological) could you offer

A 
MEDICAL
Tranexamic acid
IUD
Zoladex (GnRH agonist - shrink fibroid)
Mefanamic acid
Ulipristal acetate

SURGICAL
Hysterectomy
Myomectomy
Resection of fibroids

RADIOLOGICAL
Endometrial ablation
Uterine artery embolisation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

What delusion do you get in paranoid schizophrenia

A

Persecutory delusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What delusion do you get in depressive psychosis

A

Nihilistic delusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is it when a patient sees a red light and then realises he is being followed

A

Delusional perception

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Why would a delusional perception be relevant to the diagnosis in a patient with psychosis

A

it is a schneideran first rank symptom of schizophrenia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

Stiff neck with antipsychotic is a sign of what

A

acute dystonic reaction (torticollis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

How do you treat acute dystonic reaction

A

Procyclidine IM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

What is restlessness with antipsychotics called

A

Akathisia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

Name what receptor and the 3 pathways antipsychotics work on

A

post synaptic D2 receptors

  • mesolimbic/mesocortical
  • nigrostriatal
  • tuberohypophyseal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What 2 investigations should be done before starting on lithium

A

TFTs

Kidney function tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

A patient on lithium developls constipation, cold peripheries and weight gain what has occured

A

hypothyroidism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

What is the difference between bipolar 1 and 2

A

1 - manic episode lasting longer than a week

2 - more than one episode of depression only hypomania (mild manic episodes)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

ICD 10 of bipolar

A

at least 2 episodes where the patient’s mood and activity levels have been significantly disturbed

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

3 features of hypothyroidism

A 
weight gain 
increased appetite
dry skin
goitre
thinning of hair 
brittle nails
bradycardia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

3 neurological signs of lithium toxicity

A 
brisk reflexes
seizures
coma
coarse tremor
ataxia
slurred speech
blurred vision
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

Why is advisable to deliver a post-term fetus with no signs of labour

A

intrauterine fetal death

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

2 methods of inducing labour

A

Oxytocin (syntocinon)
Prostaglandins (misoprostol)
Amniotomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

3 features on a Bishop’s score

A 
Cervical effacement
Cervical dilation
Cervical consistency
Cervical position
Station
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

3 reassuring features on a CTG

A

HR 110-160
No decelerations
Good variability > 5sec

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
115
Q

Patient has already had a beta hCG and an ultrasound - how would you diagnose an ectopic pregnancy

A

laparoscopy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
116
Q

3 treatments for ectopic pregnancy

A

Methotrexate
Salpingostomy
Salpingectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
117
Q

4 risk factors for ectopic pregnancy

A 
previous ectopic pregnancy
PID
Smoking
Endometriosis
Ashermans
IUD
Previous surgery
Submucosal fibroids
IVF
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
118
Q

Incidence of ectopic pregnancy

A

1%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
119
Q

Recurrence rate after one ectopic pregnancy

A

10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
120
Q

3 features of a febrile seizure than would lead you to undertake further investigations

A

Focal
Lasting longer than > 15minutes
More than 1 in 24 hours
Incomplete recovery after 1 hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
121
Q

What 3 pathological conditions could be discovered upon neurological examination after a febrile seizure

A

Brain tumour
Encephalitis
Meningitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
122
Q

What should parents do if the child had another fit

A

Recovery position

Buccal midazolam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
123
Q

3 investigations of neonatal jaundice

A

FBC
Serum bilirubin
Blood film

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
124
Q

If jaundiced baby comes back in 3 weeks later what signs would lead you to think there was an underlying pathology

A

pale stool

dark urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
125
Q

What would happen to the biceps, triceps and patellar relexes immediately after hemisection of the spinal cord at t2

A

Biceps and triceps fine

Patellar - increased

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
126
Q

When spinal shock wears off what happens to the reflexes and tone below the lesion

A

hyperreflexia

increased tone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
127
Q

Vibration and proprioception are spared what column is spared

A

DCML

dorsal column medial lemniscus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
128
Q

What investigation is done for spinal cord lesion

A

MRI

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
129
Q

After a few months would he have extensor or flexor plantars

A

Extensor - upgoing plantars/Babinskis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
130
Q

2 causes of confusion and agitation in a man with prostate cancer and evidence of WCC in urine

A

Urinary retention
UTI
Prostatitis
Uraemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
131
Q

2 nursing strategies for confused patient

A

place clock in room
quiet room
well-lit room
place calendar

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
132
Q

Treatment of delirum

A

Haloperidol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
133
Q

If an elderly patient is deemed to have no capacity what needs to be sorted out

A

DNACPR

LPA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
134
Q

What MDT input is there for discharge planning

A 
OT
PT
Dr
Social worker
Psychologist
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
135
Q

Name 5 criteria for screening

A

The condition is important
The natural history of the condition is known
There is an acceptable test for the condition
There is an acceptable treatment for the condition
The screening is cost-effective
There is an agreed policy on whom to treat
There is a recognisable latent phase

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
136
Q

20 year old homosexual with erectile dysfunction name 4 chronic conditions that may lead to this in someone of his age

A 
Anxiety
PTSD
DM
MS
foreskin problems
hypogonadism
antidepressant medication
spinal cord injuries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
137
Q

2 investigations for erectile dysfunction

A

Testosterone
SHBG
Prolactin
BM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
138
Q

2 ways to reduce performance anxiety

A

Counselling

Education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
139
Q

Who do you inform in the case of a never event

A

Patient
Family
National reporting and learning service
PCT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
140
Q

When investigating a Never Event, what is the Personal Approach and what is the System Approach? Which should you use?

A

Personal approach: Holding 1 person responsible for the event

Systems approach: Identifying there are latent errors in the system and that latent + active causes come together to cause error.

Systems approach - eliminates blame culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
141
Q

1 psychological and 1 medical treatment for panic disorder

A

CBT

SSRIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
142
Q

Name 3 ICD10 symptoms for OCD

A 
Obsessions 
Compulsions
Interfere with daily life
Unsucessfully resisted
Unpleasant
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
143
Q

Maximum units for men and women

A

14

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
144
Q

He says he went from drinking wine, whisky and Beer to only drinking Wine, what symptom of dependence is this?

A

Narrowed repertoire

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
145
Q

Blood tests for alcohol dependence

A

GGT
FBC
MCV
Carbohydrate deficient transferrin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
146
Q

3 signs of Wernickes

A

Ataxia
Confusion
Opthalmoplegia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
147
Q

Combined screening test for Downs

A

Nuchal translucency
PAPP-A
bhCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
148
Q

Quadruple test for Downs

A

Inhibin A
bhCG
Oestadiol
Alpha Fetoprotein (AFP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
149
Q

4 risks of amniocentesis

A 
Miscarriage
Infection in amnion
Haemorrhage
Placental abruption
Sensitise for RhD
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
150
Q

What should you give before amiocentesis

A

Anti-D

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
151
Q

Apart from Downs name 3 over chromosomal abnormalities you can test for

A

Edwards - 18
Pataus - 13
Angelman - 15

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
152
Q

4 features that are suggestive of a malignant lesion

A 
Bone pain
Enlarged lymph nodes
hypercalcaemia
Weight loss
Irregular mass shape
Multi-ocular cyst
Ascites
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
153
Q

What 4 blood tests would you do pre-op

A

FBC - Hb, platelets
Group and save
Clotting screen
Coagulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
154
Q

A lady is found with early stage ovarian cancer what operation would you do?

A

bilateral salpingo-oophorectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
155
Q

What intraoperative procedure would you do to determine if it is malignany

A

biopsy

156
Q

9 months child has acute history, lethargy, malaise, redness in the armpit, groin region and neck. Peeling of the skin has started to occur, capillary refill of 4 seconds. Whats the most likely diagnosis?

A

Staphylococcal Scaled Skin Syndrome

157
Q

Whats the most likely organism causing SSSS, genus and species

A

Gram positive cocci

Staphylococcus aureus

158
Q

How does the organism in SSSS cause the skin to peel

A

Staphylococcus epidermolytic endotoxin damages outer layer of skin

159
Q

Little girl comes in with fluctuating fever, malaise with hepatosplenomegaly and pain in her hip with reduced range of motion, what are the two most likely diagnoses?

A

ALL

Systemic JIA

160
Q

What blood tests are done in ALL

A

FBC

Blood film

161
Q

What investigation would you do in a painful joint

A

US

162
Q

3 treatments for inflammatory diseases like arthritis in children

A

NSAIDs
Steroid injections
Infliximab
Corticosteroids

163
Q

Blood results of hyperthyroidism

A

low TSH
high T3 and T4
Autoantibodies

164
Q

Treatment for hyperthyroidism

A

Carbimazole
Radioactive iodine
Thyroidectomy
Beta blocker for adrenergic symptoms (sweating, tachycardia)

165
Q

What is a thyroid storm

A

BP, temperature and HR surge to dangerously high levels

166
Q

What is the pathophysiology of Parkinsons disease

A

Reduction in the dopaminergic neurones in the substantia nigra of basal ganglia

167
Q

2 signs in upper limb found with Parkisons

A

cog wheel rigidity
pill rolling tremor
bradykinesia

168
Q

2 medications for Parkinsons disease

A

Levo-dopa

Bromocriptine

169
Q

2 drugs that worsen Parkinsons symptoms

A

Typical antipsychotics
Antiemetics
Both block D2 receptors

170
Q

Normal pressure hydrocephalus triad

A

wet wobbly and weird

Incontinence
Ataxia
Dementia

171
Q

Woman with anorgasmia - 8 endocrine blood tests

A 
TFTs
Fasting glucose
SHBG
Testosterone
GnRH
Progesterone
Prolactin
Cortisol
FSH/LH
oestradiol
172
Q

What are the 4 approaches to couples therapy

A

Cognitive-behavioural
Integrated
Systemic
Psychodynamic

173
Q

What is need according to NICE

A

the ability to benefit from an intervention

174
Q

Example of what is supplied but not needed or demanded

A

Vaccinations

175
Q

Example of what is supplied and needed but not demaded

A

Screening

176
Q

Example of what is needed and demanded but not supplied

A

Plastic surgery

177
Q

What is the epidemiological health needs assessment

A

Looks at trends in causes and effects of health needs

178
Q

What is corporate health needs assessment

A

Stakeholders views on current needs and priorities for future provision

179
Q

What is comparative health needs assessment

A

the services in the population are compared and contrasted with those provided at a different time, place or to a different population group.

180
Q

2 flaws of comparative health needs assessment

A

Hard to find a population similar

Expensive

181
Q

4 criteria of negligence

A

was there a duty of care
was there a breech in the duty of care
did the patient come to harm
was this harm due to the breech

182
Q

What is a person centred approach to error

A

Unsafe acts are due to mental processes such as forgetfulness, carelessness, inattention, negligence and recklessness

183
Q

What is the systems approach to error

A

Humans are fallible and error is to be expected

184
Q

Paracetamol overdose blood tests

A 
Clotting - INR, PT, APTT
FBC - Hb
U+Es - creatinine
LFTs - AST/ALT 
Blood gas - increase in bircarbonate and lactate
185
Q

Treatment of paracetamol overdose

A

N-acetylcysteine

186
Q

6 screening investigations for dementia

A 
AMT
GPCOG
MMSE
Mini Cog
MSQ
MoCA
MIS
187
Q

4 issues to consider in Alzheimers

A 
Capacity
Care plan
Modification at home
LPA
DNACPR
Polypharmacy
Memantine
188
Q

Diagnosis of preeclampsia

A

High BP and protein in urine ++

189
Q

Complications in preeclampsia

A 
HELLP
Pulmonary oedema
Renal failure
Cerebrovascular haemorrhage
Eclampsia
190
Q

4 differentials for post-coital bleeding and intermenstural bleeding

A 
Cervical cancer
Chlamydia
PID
Cervical ectropion
Cervical polyps
Vaginitis
Fibroids
Uterine polyps
191
Q

2 investigations for PCB and IMB

A 
Triple swab - high vaginal and endocervical
Cervical smear
HPV testing
US
Colposcopy
192
Q

2 investigations for DVT

A

D Dimer

US of leg

193
Q

Name 3 anticoagulants and their contraindications

A

LMH - previous anaphylactic
Warfarin - oesophageal varicies
Rivaroxiban - significant hepatic impairment

194
Q

Bulky uterus

A

Fibroids

195
Q

Boggy uterus

A

Endometriosis

196
Q

Transtheoretical model

A 
Pre-contemplation
Contemplation
Preparation
Action
Maintenance
Relapse
197
Q

What can be done to help intention

A

Positive social influence
Bridge the gap
Promote self efficacy

198
Q

2 limitations to theory of behaviour

A

ignores one needs before engaging in a certain action
ignores emotions when making a decision
relies on self-reporting
assumes arritude and subjective norms can be measured

199
Q

ABG shows high pH, low CO2, normal O2 and normal HCO3 and base excess what is the causes

A

Respiratory alkalosis

Hyperventilation - blowing off lots of CO2

200
Q

3 antenatal factors the increase the risk of infection in a baby

A

Group B Strep carrier
PROM
TORCH (toxoplasmosis, rubella, CMV, herpes/HIV)

201
Q

3 components of CSF in bacterial infection

A

Low glucose
High WCC (neutrophils)
High protein

202
Q

What is a long term effect of meningitis

A

Hearing loss

203
Q

Crying infant, apyrexial, petechial rash on neck, immobile left arm

A

Blood culture
FBC
CRP
Shoulder/elbox XR

204
Q

3 Differentials for collapse

A

cardiogenic syncope
vaso-vagal syncope
seizure
TIA

205
Q

Features of temporal lobe epilepsy

A

Deja Vu
Automatisms
Difficulty speaking and understanding speech

206
Q

What is first line in reducing frequency of epileptic seizures

A

Carbamazepine

207
Q

What anti-epileptic is contraindicated in absence seizures

A

Carbamazepine

208
Q

4 things to assess for capacity

A

Understand
Retain
Weigh up
Communicate

209
Q

4 things to know for discharge planning

A

Care package
OT review
PT review
Social worker

210
Q

2 treatments for rapid ejaculation

A

Topical lidocaine STUD 100

Dapoxetine

211
Q

What is the rule of rescue

A

We have duty to safe a life where possible

212
Q

What delusion would you see in depressive psychosis

A

Nihilistic delusions

Cotard delusions

213
Q

What delusions would you see in paranoid schizophrenia

A 
persecutory
grandiose
delusions of reference
capgras delusions
fregoli delusions
214
Q

Pt sees a red car and knows the police are following him what is this called and why is it relevant

A

Delusional perception

First rank symptom

215
Q

Give antipsychotic and pt develops neck and jaw spasms what is this called

A

acute dystonia

216
Q

treatment of acute dystonia

A

Benzotropine IV/IM

Procyclidine

217
Q

Name 3 atypical antipsychotics

A 
Risperidone
Aripiprazole 
Olanzapine
Quetiapine
Clozapine
218
Q

What receptors do atypical antipsychotics work on?

A

Serotonin-dopamine D2 receptor antagonist

219
Q

What test to do in a man that claims he has a heroin addiction and would like help

A

Urine drug screen

220
Q

What 2 treatments can you give for opiate addiction

A

Naltrexone
Methadone
Buprenorphine

221
Q

3 features of dependency

A 
increased tolerance
craving
withdrawal symptoms
neglect of responsibilities and other interests
difficulty controlling consumption
narrowed repertoire
222
Q

2 blood tests in alcoholism

A

MCV
GGT
carbohydrate-deficient transferrin

223
Q

23 year old woman comes to your fertility clinic planning to have a baby. She has type I diabetes and hypertension. Taking insulin and Ramipril (an ACE inhibitor). Her BP is under control; she has a background of retinopathy and a raised HbA1c at 90mmol/mol.
4 changes to medication

A

Stop ACE i
Increase insulin
Begin labetalol/nifedipine
Start folic acid supplement

224
Q

List 2 early pregnancy risks and 3 fetal/neonatal complications with uncontrolled diabetes?

A 
Polyhydramnios
IUGR
Miscarriage
Still birth
Preterm delivery
Neonatal hypoglycaemia
Macrosomia
Shoulder dystocia
Fetal RDS
SGA
Congenital defects
225
Q

4 antenatal investigations to check her risk

A

BP
Fasting blood glucose
Urinalysis
Uterine artery doppler

226
Q

What test is to check for ovulation

A

Mid-luteal progesterone - day 21

227
Q

What 2 tests check for tubual patency

A

HSG

HyCoSy

228
Q

Which test is preferred for checking tubal patency and why?

A

HyCoSy - no radioactive contrast

229
Q

4 other female investigations for infertility

A 
TSH
FSH/LH
STI screen
Prolactin
Glucose
230
Q

What should the couple do in the mean time

A 
Have more sex
Lose weight
Stop smoking
Exercise
Diet
Folic acid
231
Q

Apart from seminal analysis what other tests could the male partner have

A

FSH/LH

232
Q

Name 4 features that would make you think of hyperthyroidism

A 
increased appetite
low weight
diarrhoea
neck swelling
sweaty
tachycardia
change in mood
thin hair
clubbing
palmar erythema
resting tremor
233
Q

Name 4 featuers than wold make you think of menopause

A 
hot flushes
night sweats
vaginal dryness
skin and breast atrophy
atrophic vaginitis
234
Q

Name 4 features that would make you think of anxiety disorder

A

insomnia
feeling of impending doom
anxious across all situations
hyperventilation

235
Q

4 treatments for anxiety

A 
Beta blocker
SSRI - paroxetine
CBT
Counselling
Short term benzo
236
Q

3 features of acute severe asthma attack in hcildren

A 
PEF 33-50%
RR >30
HR >125
inability to complete sentences
SpO2 <92%
237
Q

3 features of life threatening asthma attack

A 
Silent chest
Cyanosis
Poor respiratory effort
Hypotension
Exhaustion
Confusion
PEF<33%
238
Q

What 2 medications would you give immediately in acute asthma attack

A

oxygen

nebulised salbutamol

239
Q

low pH, high CO2, borderline/low HCO3- which 2 changes show deterioration.

A

Respiratory acidosis with mild metabolic compensation

low pH, high CO2

240
Q

Child not responding to nebulisers what drugs could you give IV

A

IV Hydrocortisone
IV Salbutamol
only give IV amniophylline if severe asthma

241
Q

6 questions to ask the parens to assess how well his asthma is controlled

A 
Wake up breathless
Exercise limitations
How often does he use his inhaler
Inhaler technique
Recent hospital admissions for exaccerbations
Daytime symptoms
Oral steroids
242
Q

3 intestinal and 3 extra intestinal signs of IBD

A

Intestinal

  • abdominal mass
  • anal skin tag
  • strictures
  • perianal abscess
  • fistulae

Extra intestinal

  • erythema nodosum
  • mouth ulcers
  • arthritis
  • uveitis
  • conjunctivitis
  • clubbing
243
Q

3 histological features of Crohns

A 
Crypt abscesses
Granulomas
Goblet cell depletion
Lymphocyte infiltration
Skip lesions
Transmural inflammation
244
Q

4 effect of steroids on 15 yo girl

A 
Increase in hair
Amennhorea
Deepened voice
Weight gain
Increased risk of osteoporosis, infections, diabetes
245
Q

42-year old plumber with Parkinsonism/Parkinsons, troubles with left arm, tremor in left hand at rest. On Metoclopramide, aspirin, statin, amlodipine - What medication is causing his Parkinsonism symptoms

A

Metoclompramide - D2 receptor antagonist

246
Q

3 cardinal signs of Parkinsonism

A

Resting temor
Bradykinesia
Rigidity

247
Q

What part of the brain is affected in Parkinson’s

A

Basal ganglia - substantia Nigra

248
Q

When writing deteriorates in Parkinsons what is it called

A

micrographia

249
Q

The patient stops the causative medication and his symptoms initially improve. However he presents a year later with worsening Parkinson’s symptoms. He is therefore given a new medication. This makes him sleepy and his wife says he goes gambling, what drug is responsible?

A

Dopamine agonists

  • Ropinirole
  • Cabergoline
250
Q

What non-pharmacological treatments can improve Parkinsonian symptoms

A

Physiotherapy
Occupational therapy
Relaxation therapies

251
Q

3 reasons that could predispose to pressure ulcers

A 
Immobile
Vascular disease
Poor nutrition
Dehydration
Bowel incontinence - local infection
252
Q

What 3 actions can be done to stop pressure ulcers and which member of MDT can help

A

Mobilisation - PT
Improve nutrition - dietician
Hygeine/regular turns - nurse
Treat incontinence - doctor

253
Q

Her hip fracture was the result of reduced bone density. Name 2 treatments which will improve her bone health

A

Bisphosphonates
Vit D
Ad-cal

254
Q

Medically fit for discharge, mobilising with a zimmer frame. Name 2 more things you ask about before sending home.

A

OT assessment of home

Carers

255
Q

Vaginismus - lady having first cervical smear, she’s very anxious about having her first genital examination? What 3 things need to be done before the examination?

A

Explain procedure
Chaperone
Full sexual hx
Any traumatic sexual experiences

256
Q

Name the 4 main types of psychosocial therapy

A

Integrative
Systemic
Psychodynamic
Cognitive behavioural

257
Q

What should GP prescribe for vaginismus

A

Incremental vaginal trainers

258
Q

3 behavioural interventions

A

Self-exploration
Sensate focussed
Couple therapy

259
Q

What is beneficiance

A

To do good - do the operation

260
Q

What is non-maleficence

A

To do no harm - resuscitation would cause more harm

261
Q

What is never event

A

A largely preventable event that should not have happened

eg - not gaining consent

262
Q

who should never events be reported too

A

National Reporting Learning System (NRLS)

Strategic Executive Information System

263
Q

Explain the system approach to error

A

Human are fallible to mistake so there should be systems in place to stop this from happening

264
Q

Explain the person approach to error

A

Error is down solely to the personal mental errors - fixation, sloth, bravado, etc

265
Q

16 year old woman brought to GP by father presenting with 6 month history of abdominal fullness on eating, alleviated by vomiting, with reduced food intake. She was unhappy with her weight and felt fat. BMI of 16. You suspect an eating disorder
3 organic causes of symptoms

A

IBD
Coeliac
Pregnancy
Gastritis

266
Q

3 tests in bulimia

A

FBC - anaemia
ESR (if high ?organica cause of anorexia)
Electrolytes - (hypokalemia, hyponatraemia)
U+Es - creatinine (breakdown of muscles)
Magnesium (magnesium deficiency can cause nausea and vomiting)
LFTs
hypercholestrolaemia
ECG

267
Q

2 features in history that would confirm diagnosis of anorexia

A

fear of gaining weight
1/2 kg loss of weight per week
amenorrhea
overvalued idea of being fat

268
Q

4 physical signs of anorexia

A 
Anaemia
Muscle wasting
Lanugo hair
Poor teeth
Oligomenorrhea
Poor circulation
Dry skin
Thin hair
Bradycardia
269
Q

Test for Downs < 12 weeks

A

Combined test:
PAPP-A
BhCG
Nuchal translucency

270
Q

Test for Downs > 14 weeks

A 
Quadrupule test:
AFP
bhCG
Oestriol
Inhibin A
271
Q

4 complications of amniocentesis

A 
Rhesus disease
Risk of PROM
Risk of miscarriage 
Risk of chorioamniotitis
Placental abruption 
Club foot
272
Q

What should a lady undergoing amniocentesis be given before the procedure and why

A

Anti-D

To prevent rhesus disease

273
Q

Name 3 other chromosomal abnormalities

A

Edwards - 18
Pataus - 13
Angelmans - 15

274
Q

What is the initial management of a child with decreased consciousness

A

ABCDE - glucose
Oxygen
Fluids

275
Q

2 causes of purpuric rash in a child

A

HSP
Meningococcal septicaemia
ITP
Leukaemia

276
Q

Low pH
Low CO2
Low bicarbonate
Low BE

What is the abnormality in the blood gas and what is the cause of this abnormality

A

Metabolic Acidosis

Sepsis

277
Q

Prophylaxis of meningiococcal sepiticaemia

A

first line Rifampicin

Ciprofloxacin

278
Q

What is need according to NICE

A

The ability to benefit from an intervention

279
Q

Define epidemiological health needs assessment

A

Looking at patterns in the cause and effect of health needs

280
Q

Define corporate health needs assessment

A

Health needs according to stakeholders

281
Q

Define comparative health needs assessment

A

Comparing the health needs to a similar population, place or time

282
Q

Sheltered accommodation 45 year old Down syndrome patient is presenting with a 6 month history of agitation, incontinence of urine, attacking other residents,
Suspected depressive syndrome 3 features to clarify diagnosis

A

Anhedonia
Anergia
Low mood

283
Q

2 other differentials of previous case

A

Urinary tract infection

Early onset dementia

284
Q

2 further investigations

A

Urinalysis

AMT

285
Q

Non-pharmacological interventions

A

CBT
Anger management
Mindfulness

286
Q

Steps to mental capacity

A

Understand
Retain
Weigh up
Communicate

287
Q

Key principles to mental capacity

A

A person is assumed to have capacity until they a deemed not to have capacity
All steps must be taken to ensure that the person is able to make a decision for themselves
An unwise decision does not mean someone lacks capacity
If a decision is made for someone who lacks capacity it must be done in their best interests
The decision must be the least restrictive possible

288
Q

What 3 things are required for a DOLS

A

lack the capacity to consent to their care/treatment

arrangements are under continuous supervision and control

are not free to leave

in a hospital or care home

not under the mental health act

> 18

289
Q

What does DOLS ensure

A 
safety of the patient
right to appeal
best interest
arrangements are reviewed regularly
someone is appointed to represent you
290
Q

How long does a DOLS last

A

12 months

291
Q

50 year old woman presents with her friend following ?seizure. Her friend reports that she felt confused, and then had twitching of her right eye, before collapsing to the ground shaking. This lasted 3 minutes before she started to regain consciousness. She is still confused.
You conclude that what occurred was an epileptic attack.

What 3 features from the history support epilepsy as a diagnosis?

A

Prodromal phase (aura)
Tonic-clonic shaking
Post ictal confusion

292
Q

2 non blood investigations

A

EEG
ECG
CT

293
Q

How long can someone not drive after a seizure

A

12 months

294
Q

What are the chances of having another seizure after a first seizure

A

40-50%

295
Q

First line medication or seizure

A

Carbamazepine

296
Q

28 weeks gestation, following a placental rupture. Then when he was 2 weeks old he suddenly turned gray and non responsive.

Apart from NEC, what 2 conditions could cause this presentation?

A 
RDS
Intraventricular haemorrhage
Hypothermia
Hypoglycaemia 
Sepsis
297
Q 
Acidotic
	Low O2
	High CO2
	Normal bicarb
	Normal BE

What does the blood gas show?

A

Respiratory acidosis

298
Q

2 bowel specific complications of NEC

A

Bowel perforation
Stricture
Necrosis

299
Q

3 radiological findings of NEC

A

XR
Distended bowel loops
Portal venous gas
Bowel wall oedema

US
Intramural gas
Bowel wall thickening
Free fluid

300
Q

2 immediate non-surgical interventions for NEC

A

NBM
Broad spectrum antibiotics
Gastric aspiration

301
Q

SE of B blocker

A 
nausea
hypotension
vomiting
headache
cold peripheries
impotence
302
Q

SE to statin

A

headache
GI disturbances
muscle aches
rhabdomyolysis

303
Q

SE to clopidogrel

A

GI disturbance
Bleeding
thrombocytopenia

304
Q

SE lansoprazole

A

GI disturbances
headache
low magnesium
osteoporosis

305
Q

Two weeks later, he is feeling exhausted on exertion and is trying to remain as fit as he used to be. He presents with 100/80 BP. The cardiology discharge form advised that you titrate bisoprolol to the highest dose.

What would you do? And why?

A

Titrate dose up keep an eye on the blood pressure if consistently low then ask cardiologist
Consider switching to verapamil (off-label)

306
Q

What non-pharmacological measure would you advise for him

A

Dietary measures
Smoking
Alcohol

307
Q

4 domains of the geriatric assessment and the MDT for each

A

Medical (doctor)
Mental (psychiatrist)
Social (social worker)
Functional (OT)

308
Q

Patient is breathless, despite being on maximal medication.

What drug type could you give to treat this?

A

Oxygen

309
Q

What non pharmaceutical intervention could you do?

A

PT

310
Q

3 things to consider in an advanced care life plan

A

Advanced decision (DNACPR)
Statement of wishes and preferences
LPA

311
Q

Woman presents with irregular cycle since a menarche of 12. She has a 32-40 week cycle, that she would like to be more regular.
Give two possible causes of irregular cycle

A

PCOS
Hypothyroidism
Under or overweight
Stress

312
Q

If she had hirsutism and weight gain, what two tests?

A

SHBG
Testosterone
LH/FSH
US of ovaries

313
Q

What two non hormonal interventions to control dysmenorrhoea and menorrhagia?

A

Dysmenorrhoea - mefanamic acid

Menorrhagia - tranexamic acid

314
Q

What 3 management options would you advise

A 
Lose weight
Meformin
OCP
IUD
Depot provera
Implanton
315
Q

Man presents with failure to ejaculate (2 endocrine, 2 neuro and 2 medicated side effects) 6 causes

A

High prolactin
Low testosterone

Diabetes
MS

SSRIs
Beta blocker

316
Q

He has recently left his wife for a new partner, and is happy in this relationship
List two psychosocial reasons for his symptoms

A

Performance anxiety

Inadequate stimulation

317
Q

2 psychosocial interventions

A

Integrative couple therapy

Systemic couple therapy

318
Q

What are you trying to rule out during a neurological exam after a febrile seizure

A

Meningitis, Encephalitis

Neck stiffness, photophobia, rash

319
Q

Domains and members in a Comprehensive Geriatric Assessment

A

Medical - doctor, pharmacist (meds, adv directive)
Mental - psychologist (MCA, mood)
Social - social worker (carers)
Functional - OT, PT (housing, transport)

320
Q

3 investigations for an ectopic

A

beta hCG
US
laparaoscopy

321
Q

Risk facotrs for ectopic

A 
submucosal fibroids
IUD
PID
chlamydia
prev surgery
ashermans
322
Q

Features on a Bishops score

A 
cervical effacement
cervical dilatation
cervical consistency
cervical position
station
323
Q

Reassuring features on CTG

A

HR 110-160
variability >5bpm
no decelerations

324
Q

generalised seizure medication

A

sodium valporate

325
Q

focal seizure medication

A

carbamazepine

326
Q

Investigations for extent of pre-eclampsia

A

CT - CVH
CXR - pulmonary oedema
U+E - renal failure
fundoscopy - papilloedema in raised ICP

327
Q

What are the 4 factors of the health belief model?

A

an individual will change if they:

  • believe they are susceptible to the condition
  • believe it has serious consequences
  • believe that taking action will reduce their susceptability
  • believe that the benefits outweigh the costs
328
Q

What are the 3 components of theory of planned behaviour?

A

attitude
subjective norm
perveived behavioural control

329
Q

5 stages of bridging the gap (ToPB)

A 
perceived control
anticipated regret
implementation intentions
preparatory actions
relevance to self
330
Q

Paracetamol overdose bloods

A 
Clotting - INR, PT, APTT
FBC - Hb
U+Es - creatinine
LFTs - AST/ALT 
Blood gas - increase in bicarbonate and lactate
331
Q

2 limitations to the theory of planned behaviour

A

ignores one needs before engaging in a certain action
ignores emotions when making a decision
relies on self-reporting
assumes arritude and subjective norms can be measured

332
Q

Investigations for rapid ejaculation

A

TFTs (hyperthyroidism)
PSA (prostatitis)
Medications (SSRIs)
Comorbid sexual problems (ED)

333
Q

Treatment for rapid ejaculation

A 
STUD 100
Dapoxetine
Pelvic floor exercises
Couples psychosexual therapy
Sensate therapy
Stop start technique
Masturbating before sex
334
Q

Investigation for delayed ejaculation

A 
Urinalysis - sperm in retrograde ejaculation
Low testosterone 
Glucose - diabetes
PSA - enlarged prostate
B12/folate - alcoholism
335
Q

Treatment for delayed ejaculation

A 
PSGP
individual therapy
couples therapy
kegel exercises
vibration and superstimulation
336
Q

Causes for ED

A 
DM
CVD
neurological disorders
androgen deficiency
high prolactin
prostate surgery
SSRIs 
antihypertensives
age related changes
infective sexual stimuli
pain
veno occlusive disorder
337
Q

What is the Luria test

A

test for frontal lobe pathology

338
Q

Emergency treatment for an aggressive patient

A

lorazepam

339
Q

Police sections

A

135 - section at home

136 - section in public

340
Q

transmission of hepatitis

A 
Hep A - poo
Hep B - sex and blood
Hep C - blood
Hep D - have to have Hep B
Hep E - food
341
Q

Drugs that are contraindicated in pregnancy

A 
trimethoprim
NSAIDs
warfarin
benzos
ACE-i (in 2nd and 3rd trimester)
342
Q

Facial features in Russell Silver syndrome

A

triangualr shaped face

carp shaped motuh

343
Q

treatment of essential tremor

A

propanolol

344
Q

coeliac disease histology

A

crypt hyperplasia
villious atrophy
increase in T lymphocytes

345
Q

How long do you have to carry antidepressants on for

A

6 months after remission

346
Q

How do you investigate PROM

A

speculum

347
Q

When do you notify about nitifiable diseases and how

A

inform the local health protection team as soon as you get there is a diagnosis DO NOT WAIT FOR LAB RESULTS
send a form within 3 days
or if urgent case call within 24 hours

348
Q

When is aspirin given prophylactically in preeclampsia

A

12 weeks

349
Q

What does a NAAT test look for

A

its a first void urine looking for chalmydia and gonorrhea

350
Q

first line investigation for an overdose on a TCA

A

ECG - arrhythmias

351
Q

drugs that cause gynaecomastia

A 
spironolactone
salbutamol
steroids
TCAs
ABX
diazepam
digoxin
CCB
metoclopromide
352
Q

gram postitive diplococci

A

strep pneumoniae

enterococcus

353
Q

gram negative diplococci

A

neiserria

moraxella

354
Q

dolls eye reflex is indicative of whaat

A

brainstem death

355
Q

treatment of acute alcohol withdrawal

A

chlordiazepoxide

356
Q

Blood gas in a salt losing crisis

A

metabolic acidosis
hyponatraemia
hyperkalaemia

357
Q

Treatment for gestational diabetes

A

insulin is gold standard

but metformin is safe

358
Q

name of rash in rheumatic fever

A

erythema marginatum

359
Q

investigation for scarlet fever

A

antistreptolysin O titre

360
Q

treatment of scarlet fever

A

penicillin V

361
Q

management of breakthrough bleeding with progesterone implant

A

COCP on top for 3 months

362
Q

management for nephrotic syndrome

A

prednisolone
fluid restriction and low salt diet
IV furosemide + albumin

363
Q

antihypertensive that cuases facial flushing

A

CCB

364
Q

treatment of transient synovitis

A

NSAIDs

365
Q

Meconium ileus is associated with what disorder

A

CF

366
Q

Define panic attacks

A

spontaneous
not situation specific
periods of normality (not constant worry like GAD)

367
Q

Types of bias

A

information bias
selection bias
publication bias

368
Q

Non-causal associations

A

bias
chance
reverse causality
confounding

369
Q

Sensitivity

A

a/a+c

370
Q

Specificity

A

d/b+d

371
Q

PPV

A

a/a+b

372
Q

NPV

A

d/c+d

373
Q

If population increases what happens to sensitivity and PPV

A

No change to sensitivity or specificity
PPV increases
NPV decreases

374
Q

Investigations for TIA

A

Carotid doppler

ECG

375
Q

What would you do on clinical examination on a man with a suspected TIA

A

check pulse for AF

auscultate the neck for carotid bruits

376
Q

what is attributable risk

A

absolute risk in one group - absolute risk in the other group

377
Q

what is relative risk

A

absolute risk in one group divided by absolute risk in the other group

378
Q

incidence

A

number of new cases over total population at risk at that time

379
Q

Define epidemiological health needs assessment

A

assess need based on the extent of the problem

380
Q

What is normal pressure hydrocephalus

A 
Enlarging of ventricles to compensate for increase in CSF
wet wobbly weird
incontinence
ataxia
confusion/dementia
381
Q

Treatment for hyperthyroidism

A

Carbimazole
Radioactive iodine
Anticholinergics - sweating
B-blockers - HTN

382
Q

What would GP tell patient about after diagnosis hyperthyroids

A

Safety net warning signs
Side effects of drugs
opthamology referral

383
Q

ICD10 of OCD

A

failure to resist behaviour
thoughts are repetitive and unpleasant
originate in the mind (pt aware of this - insight)
carrying out the compulsions is not pleasurable in itself

384
Q

Fears in OCD

A

fear of making a mistake
fear of hurting self
fear of hurting others

385
Q

When is the quadruple test done

A

after 14 weeks

Previous exam questions (1 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions